Individual provider Active NPI

Abigail S Keller, AU.D.

  • Audiologist
  • Weymouth, MA
National Provider Identifier
1992995989
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
868 Issued in MA
Practice address
541 Main St Ste 418
Weymouth, MA 02190-1845
Phone
(781) 337-6860
Fax
(781) 337-2103
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 868 MA Primary
Audiologist-Hearing Aid Fitter 237600000X 868 MA

Addresses

Primary practice location

541 Main St Ste 418
Weymouth, MA 02190-1845

Mailing address

541 Main St Ste 418
PO Box 134
Weymouth, MA 02190-1845
Phone (781) 337-6860

Other identifiers 1

IdentifierTypeStateIssuer
868OtherMAMA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070822001042 MA Practitioner - Qualified Audiologist 8224120233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Shore Hearing Center LLCGroup PAC ID 0042513780, 9 clinicians

Practice addresses (Care Compare)

541 Main St
Suite 418
Weymouth, MA 02190-1845
Phone (781) 337-6860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
868MAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Hearing Center, LLC Audiologist CurrentSince Jan 4, 2016 Accepting new patients
South Shore Ear Nose and Throat P.C. PastSince Jan 3, 2012 Accepting new patients

Locations

541 Main St
Ste 418
Weymouth, MA 02190
Phone (781) 337-6860

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1992995989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 MAIN ST STE 418",
            "address_2": "PO BOX 134",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021901845",
            "telephone_number": "781-337-6860",
            "fax_number": "781-337-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 MAIN ST STE 418",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021901845",
            "telephone_number": "781-337-6860",
            "fax_number": "781-337-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ABIGAIL",
        "middle_name": "S",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "868",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MA",
            "license": "868",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA LICENSE",
            "identifier": "868",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.